The Young Patients

British children's hospitals were originally intended for boys and girls aged from two to about ten years. The founders assumed that older children would continue to be treated in adult hospitals and sick babies would remain at home with their mothers. Usually however the medical staff did not take these rules too literally and soon were admitting children of all ages on the principle that very sick patients could not in all conscience be turned away. As we have seen, management committees often turned a blind eye to infringements of age regulations so long as these were not deemed excessive. At Birmingham infants under the age of one year were not admitted until the 1870s but from then on steadily became more numerous. At the same hospital, children over the age of ten were kept out until the middle seventies but thereafter their numbers also increased. Physicians naturally enough wanted their patients to cover the whole spectrum of childhood and, since there was no special hospital for babies as existed in Paris, management committees found it difficult to enforce the exclusion rule. At Great Ormond Street 1,058 patients were admitted in 1878 of which 28, or 2.6 per cent, were under the age of two years.' By 1886 this percentage had climbed to 19.3, with 211 out of 1,094 patients being officially under age. As indicated by Charles West in his protest against a proposal made at that time to establish a ward specifically for infants, it was not clear how many babies died while at Great Ormond Street since the reported statistics did not include the age of fatal cases.2 However, only infants were admitted with marasmus, or severe wasting, and West observed that all six patients so diagnosed on admission in 1886 had died in hospital, suggesting that it was not the right place for the care of severely malnourished babies (nor for any others, in his opinion). For the time being the proposal for an infant ward was shelved. Ifideed, in spite of considerable medical lobbying in children's hospitals for such accommodation, only the East London had acquired a ward dedicated to the care of infants by the end of the century. The rest had to make do with mixed wards. The mortality statistics for infants at the East London discouraged emulation. In 1893 that hospital admitted 498 children under the age of two years representing 38.6 …